Whenever a new infectious disease emerges, contact tracing is public health’s most powerful weapon for tracking transmission and figuring out how best to protect the population.
每当一种新传染病出现时，公共卫生部门就需要追踪传播路径并确定保护国民的最佳方案，而追踪接触者就是其最强大的武器。
But now, as coronavirus cases are surging in hot spots across the United States, the proven strategy’s effectiveness is in doubt: Contact tracing failed to stanch the first wave of coronavirus infections, and today’s far more extensive undertaking will require 100,000 or more trained tracers to delve into strangers’ personal lives and persuade even some without symptoms to stay home.
现在，随着新冠肺炎病例在美国各热点地区大幅增加，这项历经考验的策略的有效性却受到质疑：它没能遏制第一波病毒传染，而且今天这项工作的规模过于庞大，需要至少10万名训练有素的追踪员，探究陌生人的个人生活，甚至劝说一些没有症状的人呆在家里。
“We don’t have a great track record in the United States of trust in the public health system,” said David C. Harvey, executive director of the National Coalition of STD Directors. Ever since the 40-year Tuskegee experiment, which withheld treatment for syphilis from poor black men, officials have had to make special efforts, he said, to reach those now “disproportionately impacted by covid who are African Americans and Latinos.”
美国全国性病科主任联盟负责人戴维·C·哈维说：“在美国，人们向来对公共卫生系统缺乏信任。”长达40年的“塔斯基吉实验”阻止贫困的黑人梅毒患者接受治疗。自该丑闻被曝光以来，官员们就必须付出额外努力才能与那些非洲裔和拉美裔患者取得联系。在目前受到新冠肺炎影响的人群中，这些人群的比例异常地高。
People wait for a distribution of masks and food in the Harlem neighborhood of New York, US, April 18, 2020. [Photo/Agencies]Still, as states relax restrictions, public health experts say wide-scale contact tracing is the price that must be paid to reopen safely without reverting to the blanket shutdowns that put nearly 40 million Americans out of work. Time is of the essence, they say, taking advantage of the drop in cases resulting from the shutdowns.
尽管如此，公共卫生专家说，随着各州放松限制措施，要想安全地重启经济、避免再次陷入导致近4000万美国人失业的全面封锁状态，大规模追踪接触者是必不可少的。他们说，时间是关键因素，要利用好病例数量因封锁措施而下降的这段时机。
“Contact tracing is finding the next generation before they happen, getting ahead of that transmission cycle to stop it,” said Emily Gurley, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health and the instructor of the school’s new six-hour online contact-tracing course. Gurley doesn’t believe the strategy will stop transmission but that, in concert with testing and other measures, it can prevent the disease from spreading exponentially.
约翰斯·霍普金斯-布隆伯格公共卫生学院流行病学家、该学院最新版6学时接触者追踪线上课程导师埃米莉·格利说：“追踪接触者就是预先找到下一代病例，要赶在传播周期之前阻止它。”格利认为这一策略并不能阻止疾病传播，但配合检测等措施，可阻止新冠肺炎加速扩散。
Right now, though, the virus is showing signs of taking the lead again, as states relax restrictions on large gatherings and welcome customers back into bars, restaurants and movie theaters. Cases are on the rise in more than 20 states across the country, with new highs in Arizona, Texas and Florida.
不过就目前而言，随着各州放松对大型聚会的限制并鼓励消费者重返酒吧、餐厅和电影院，病毒呈现出卷土重来的迹象。在美国20多个州，确诊病例再次增长，亚利桑那州、得克萨斯州和佛罗里达州的确诊病例增量达到新高。
In Arizona, Gov. Doug Ducey reopened the state before local health departments had trained its new army of contact tracers, said Will Humble, former director of the state’s health department.
亚利桑那州前卫生局局长威尔·亨布尔说，州长道格·杜西在当地卫生部门训练新的接触者追踪员队伍之前就重启了经济。
Humble described case investigation and contact tracing as key elements of a multipronged response, including mask-wearing and social distancing.
亨布尔认为，调查病例和追踪接触者是多管齐下应对疫情的关键要素，其他应对措施包括佩戴口罩和保持社交距离。
Texas, also seeing a dramatic surge, has relaxed restrictions after hiring about 3,000 of the 4,000 contact tracers Gov. Greg Abbott said in April he planned to have in place as part of his reopening strategy.
得克萨斯州的确诊病例同样大幅增加。该州在雇用大约3000名接触者追踪员之后放松了限制。州长格雷格·阿博特4月份曾表示，作为重启战略的一部分，该州将部署4000名追踪员。
Michael Sweat, director of the Center for Global Health at the Medical University of South Carolina, said that state’s health department, which has suffered from long-term underfunding, was trying hard to ramp up contact tracing as parts of the state suffer “worrisome micro-epidemics.”
南卡罗来纳医科大学全球卫生中心主任迈克尔·斯韦特说，在南卡罗来纳州部分地区出现“令人担忧的小规模疫情”之际，该州卫生部门虽然长期资金不足，但仍努力加大接触者追踪力度。
The University of California at San Francisco has been tapped by the state to create a Pandemic Workforce Training Academy that will train as many as 3,000 people for the state’s 58 county health departments, many of them focusing on low-income communities where requests to self-isolate can be financially devastating.
加利福尼亚州委托加利福尼亚大学旧金山分校成立了一个“大流行病工作者培训学院”。该学院将为该州58个县级卫生部门培训多达3000人，其中很多人将专注于低收入社区，因为自我隔离措施可能给那里的居民造成严重的财务损失。
In San Francisco, librarian Ramses Escobedo, who became a contact tracer after two weeks of training, said the health department gave out a 60-page instruction document. “It has information from the scripts you’re supposed to follow, the questions you’re supposed to ask.”
在旧金山，图书管理员拉美西斯·埃斯科比多在经过两周的培训后成为了一名接触者追踪员，他说卫生部门发放了一份60页的指导文件。“文件中包含你应该遵循的信息和你应该问的问题。”
Of the 30 people Escobedo spoke to in his first three weeks as a contact tracer, only one refused to answer his questions.
在埃斯科比多作为接触者追踪员最初三周询问的30人中，只有一人拒绝回答他的问题。
